610
Summary
611
THE PROBLEM
611.1
COST VS. PERFORMANCE
Over the years there has been a steady increase in the construction cost
of hospitals, and recently there has been a rapid escalation of these costs.
Because of the long period from inception to occupancy of a field station,
typically seven to eight years, the Veterans Administration is not only
denied the use of the building as rapidly as desired, but the capital cost is
increased by this escalation. At the same time, rapidly advancing medical
technology calls for facilities that can respond efficiently to changing
needs. A larger proportion of the VA's capital budget is allocated to
alteration and renovation of existing hospitals than to the construction of
new hospitals. Traditional modes of construction are not providing
adequate adaptability, nor, in fact, are they fully meeting current user
needs in terms of general performance.
611.2
CONVENTIONAL DESIGN AND CONSTRUCTION
Traditional procedure has tended to underemphasize many
of the interrelationships between components and
subsystems which significantly affect the overall cost,
performance and adaptability of buildings. This tendency
has produced inefficiencies at several levels:
1. Manufacturers develop specialized products without
reference to specific ways in which they will be combined
with the products of other manufacturers. The A/E must
therefore in effect design a different building "system"
each time he deals with a new building under new
circumstances. Normal design schedules and budgets
do not permit serious systems analysis, so the result is
usually a composite of performance compromises,
unintentional experiments, and vast numbers of special
condition details.
2. Building and plan configurations tend to be overdesigned, as if they
were to remain unaltered in any way for fifty years. The organization of
building services (mechanical, electrical, etc.) on the other hand, is
usually underdesigned, on the apparent assumption that as concealed
elements, their configuration is of no consequence.
3-1
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